The uterus, or womb, is central to the female reproductive system and under normal circumstances is held in place within the pelvis by its attachment to the Fallopian tubes, as well as various ligaments and muscles. Certain events, such as childbirth involving a difficult labour, and vaginal deliveries, can weaken the tissues holding the uterus in place. This, coupled with the natural ageing process and a decrease in the oestrogen hormone levels result in the uterus moving down, and into the vaginal canal. This is the condition known as a prolapsed uterus.

It is possible for the uterus to ‘sag’, and in some cases come out of the body completely. This process occurs in several stages or degrees.

First degree

The cervix begins to descend towards and into the vagina.

Second degree

The cervix moves further down and into the vaginal opening.

Third degree

The cervix moves so that it is outside the vagina.

Fourth degree

The whole of the uterus descends to the point where it is outside of the vagina. This stage of a prolapsed uterus is also known as procidentia, and it’s caused by a weakness in all of the ligaments that should support the uterus and hold it in place within the pelvis.

Further conditions

There are several other conditions that are often associated with a prolapsed uterus. They cause a weakening of the ligaments and muscles that should hold the uterus in place, but instead allow the prolapse to occur. These conditions include Cystocele, which is a herniation, or ‘bulging’ of the uppermost part of the front vaginal wall, caused by a portion of the bladder encroaching into the vagina. It can cause several bladder problems, including urine retention, or an urgent or frequent need to urinate.

Another common condition associated with a prolapsed uterus is Enterocele, which is the herniation of the vagina along its upper most side, due to a portion of the small intestines protruding into the vagina. This results in a pulling sensation when standing, as well as backache, which is relieved upon lying down.

Finally, the protrusion of the back virginal wall, sometimes caused by the rectum bulging forwards, can cause a prolapsed uterus. Known as Rectocele, this condition can result in difficult bowel movements.